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VBAC Cubby - vaginal birth after cesarean

Difference in a VBAC Between Labor Pain and Rupture Pain
by Donna Harvel Balo ARNP, CNM, MS
Donna BaloQ. I had a c-section after a "failed induction". I was 14 days overdue, and I never went into labor. My question is about uterine rupture. If my body never experienced the pains of labor, would I know the difference in a VBAC between labor pains and rupture pains?

Also, if I wanted to get pain medication like an epidural, would I even feel if I had a rupture? Are pain meds even permitted? I am terrified that something is going to happen to me.

Should I be concerned if my OB cannot provide stats re: successful vbacs vs attempted vbacs, number of repeat c-sections?

A. I have personally never seen a uterine rupture. I did have one VBAC patient that thought the pain she was having was a rupture, but when they did another c-section, her uterus was intact. There are other clinical markers that are looked at besides pain, that point towards a rupture.

There had been concerns in the past about whether it was a good idea to give a VBAC patient an epidural, in case she wouldn't feel rupture pain. In fact, many women who have been VBACs have had pain meds including epidurals. To my knowledge, epidurals have not affected the detection of a rupture. Ask your doc about this. One of the cautions is the aggressiveness of inductions.

Many docs don't keep statistics, so I don't know that it would concern me. More importantly to me, is the philosophy of the doc. Does the OB really believe VBACs are possible and a good idea?

Remember there are many effective means of pain control besides epidurals and analgesics! Consider hiring a doula.

You have time to research and gather info and come to terms with your feelings. This is a decision that you must be comfortable with, whatever that decision is. Good luck!

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